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Two Indeterminate WB without Elisa – Anxiety HELP!!

I had unprotected sex 1 time with a girl the week after she got tested. I saw her results the day we had unprotected sex. I am not too sure about her history before slept together, she states she was in a monogamous relationship before that. Below are the times after I had unprotected sex with her.

At 6 weeks – I went for a physical and requested to be tested. I was given a Western Blot with no ELISA. The results came back indeterminate because it showed one band, p55 only.

At 8 weeks – I went back to my primary care physician and they again did a Western Blot with no ELISA. The results came back indeterminate this time showing a different band, p51 only.

At 9 weeks – I went to a specialist, she did a ELISA and RNA PCR. Both came back non reactive and not detected.

We are now at week 14 and even after getting my results at week 9 I am very anxious. I keep thinking something still might be wrong. Why did my blood show these random proteins? Why did p55 go away and p51 come? If my ELISA was negative AFTER the Western Blots does that mean I am 100% negative? Are there false negative with RNA PCR?

The thing is before I got my results I slept with this girl again but it was protected. 2 days before the first WB was taken, maybe the condom didn’t work and I was showing the first band? Are condoms 100% effective if it didn't break? Also within the last three months I slept with my ex-gf unprotected who I was in a monogamous relationship with for 2 years, she has been tested since this happened, was negative, and she did not sleep with anyone else.

Do I need further testing? I was thinking of getting tested 13 weeks after the last time I had protected sex with her, but even the thought having to get tested makes me have an anxiety attack.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
This is exactly the reason why testing should never start with WB, which was never designed for use as the initial or only HIV antibody test.  If your ELISA had been done first, as is standard, none of the rest of this would have ever come up.

That will have to do it for this thread.  Feel free to take further discussion over to the HIV community forum.
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Avatar universal

For anyone reading this thread:

Unfortunately, sera from some noninfected individuals show some reactivity to 1 or more antigens if tested by Western blot. This reactivity may occur in as many as 15% of normal noninfected persons, and many times occurs in persons who are nonreactive by screening assays. Therefore, if ELISA-nonreactive sera are tested by Western blot, many will result in an indeterminate profile. Most indeterminate results show only weak reactions to the Gag proteins (mostly p17, p24 and/or p55); other patterns occur but are less frequent. Any Western blot reactivity that does not meet the requirements for being positive or negative must be considered indeterminate.

Some individuals who exhibit indeterminate results (eg, reactivity to p24 and p55) later seroconvert, demonstrating that a p24 and p55 profile can indicate early infection. Conversely, other individuals may have the identical profile for long periods of time (years) and never seroconvert (ie, they are not infected). In fact, most indeterminate Western blot results from noninfected individuals exhibit the p24 and/or p55 profile. Therefore, an indeterminate Western blot result cannot predict early infection.

http://****.ucsf.edu/
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Avatar universal

Thanks Dr HHH,

My Dr told me cross reacting antibodies, but had no specific answer. The occurrence of p55 in my blood and then the ELISA not catching it makes me uncertain about these results. I guess the fact that if I were to have been infected the antibodies would have increased and 3 weeks after my first WB the ELISA came back negative is a good sign. I have read from your own posts that a negative combination of PCR RNA and ELISA is very conclusive.  A persons blood should either have antibodies or the virus. Is that correct?

I will also make a follow up appt with my Dr when I get an ELISA again.

I apperciate your assistance and think this forum is a great service to the global community.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
The answer to question 3 is yes, you are correct.  I don't know the answers to questions 1 and 2; I believe nobody knows why some people have indeterminate WBs, whether p55 or any other band.  I already told you that your own specialist undoubtedly knows all this stuff better than I do.  That's where to go with further questions.
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Avatar universal

Three final questions:

1) If my blood does have the p55 antibody in it, wouldn't the ELISA be positive because it looks for all the antibodies in the Western Blot? I am scared to get tested again and the ELISA will find this p55 and I have to go through a series of testing and waiting.

2) If I am not infected, do you know any reason why my blood would have p55 in it?

3) Finally, since my two western blots were done two weeks apart, if I were infected the western blot should have shown a progress in the number of antibodies, correct?
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Your partners' risks and HIV status are irrelevant.  Your test results prove you weren't infected.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
You have been given accurate advice, and almost certainly the HIV/AIDS specialist you saw is more knowledgeable about indeterminate HIV Western blots than I or Dr. Hook.  My understanding is that P55 or P51 bands, appearing alone, never indicate HIV infection.  IThe close numbers suggests it really was the same band both times, just interpreted slightly differently.  The numbers refer to positions on a paper strip.  You can understand that P51 and 55 would be very close to one another, and easily mis-measured; and that they are quite distant from the more classical P24 and P120 bands that are associagted with true HIV antibody.  However, as I said, this is definitely outside my area of sophisticated understanding.  If your specialist has a different explanation or interpretation, s/he is the one to pay attention to, not me.

In other words, you can and should view your test results exactly the same as if the results were totally negative.  This would be the case even without the negative ELISA and RNA tests, but those results prove the point.  You do not need further HIV testing, unless your HIV/AIDS specialist suggests otherwise.

I hope this helps.   Best wishes--  HHH, MD
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Avatar universal

I just wanted to note that the girls results were negative the day I slept with her unprotected.
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